Science is more than a body of knowledge. It is a way of thinking; a way of skeptically interrogating the universe with a fine understanding of human fallibility. If we are not able to ask skeptical questions, to interrogate those who tell us that something is true, to be skeptical of those in authority, then, we are up for grabs for the next charlatan (political or religious) who comes rambling along.

You're listening to the Skeptics' Guide to the Universe, your escape to reality.

S: Hello, and welcome to The Skeptic's Guide to the Universe. Today is Wednesday, May 14th, 2014, and this is your host, Steven Novella. Joining me this week are Bob Novella,

B: Hey, everybody!

S: Rebecca Watson,

R: Hello, everyone.

S: Jay Novella,

J: Hey guys!

S: Evan Bernstein,

E: Good evening, folks.

S: And we have a special guest rogue this week, Aija Moon! Aija, welcome to The Skeptic's Guide!

AM: Hi!

S: So, Aija, you are here because you won the auction at TAM last year, is that right?

AM: That's correct.

S: So you actually thought this would be worthwhile to come on the show?

(Rogues laugh)

R: We are so sorry.

AM: It was quite the entertaining experience for me because Rob had said to me, "Hey, let's go to TAM." And I said, "Okay, sure." And wasn't feeling that good. He's like, "Come up here! You're gonna miss it!" And I came in just as you guys started the auction. I was like, "Well, I can't miss out on that." So, into the auction I went.

J: Aija, do you frequently hear the joke, "You could put your weed in there?"

AM: (Laughs) No, actually. I don't hear that very often. I don't get enough time to spend with the patients, or with the employees that I have there.

B: Jay, I wonder how many people do that? But that's from a skit, from Saturday Night Live that we just ran with for the past 15 years. It's just such a funny (inaudible).

E: Longer than that. Oh my gosh!

B: Really?

J: So, Aija, do you buy yours? Do you grow it? What do you do?

AM: I personally can't grow any marijuana. I look at a plant the wrong way, and it dies (laughs). I do buy it from Health Canada. We've now just had a changeover in the MMAR program to the MMPR program; where the government has decided where they don't want people to be growing it at home, and that you should be buying it from commercial growers.

J: Wow!

AM: And we have a huge court case going up against Health Canada right now where John Conroy, who is a huge lawyer, here in Canada, has decided to make a repeal on the decision.

R: Are you saying that it's going to be made illegal for people to grow it at home? Or that it's just discouraged.

AM: Yeah, it's going to be illegal.

R: Oh. Do you support that legislation?

AM: I think that the people that are growing at home definitely should have a little bit more guidelines to what they're doing. I don't think we should take away their right to grow at home, but definitely, we need to be more involved in what they're doing, and show them the right way to do things.

R: I can't think of another sort of substance that's regulated in that way. Even alcohol, people are allowed to make their own alcohol at home, so it seems to stand to reason that they should be allowed to grow their own plants at home as well.

S: But only certain amounts, right? You can't mass produce it at home.

R: Right, yeah.

S: Because then you're a distillery, so ...

R: Right.

S: Yeah, 'cause it's just limiting it to a certain amount.

AM: The government's also limited how much marijuana you're allowed to possess at any one time.

R: Right.

J: Except for you, of course.

AM: Well, I do have a limit as well; it's 150 grams per person. And, of course, whatever you have in your dispensary is the medical facility. So that has of course a different amount within the facility. Absolutely. It's like 92, you could bake with it, and you can also smoke it.

May 17th 1955
Dr Nathan Kline testified before Congress about his research on the drug reserpine, which led to the passage of the Mental Health Studies Act.

R: Speaking of awesome drugs (laughs), on this day in history – today's May 17th that this podcast is going out – and back in 1955, on May 17th, Dr. Nathan Kline testified before the United States Congress to talk about his work with the drug reserpine. Kline was testifying in order to influence Congress to pass the Mental Health Studies Act of 1955], and he became a big advocate in Washington to convince the government to fund studies on things like antidepressants because he basically founded the field of psychopharmacology.

So, without Nathan Kline, we maybe wouldn't have the wide variety of awesome antidepressants, and anti anxieties, and all of those great drugs that we have today. You would just have pot, which would be awesome, but (laughs), maybe not the best for everybody.

Reserpine is no longer used today because of all of the bad side effects and things, but back in the day, apparently, Ghandi used it as a tranquilizer. But in the '50's, it was used to block the uptake of norepinephrine and dopamine. What does that mean, Steve?

R: It was also used for patients suffering from Huntington's disease, apparently. But, like I said, it's, it might still be used some places, at some times, but for the most part, it's rarely used because of side effects, which included the possibility of depression and suicide, although that was never fully proved. But yeah, there are much better drugs now. But, yeah, that kind of, it paved the way for more research into psychopharmacology.

S: It's interesting to note that prior to modern psychopharmacology, I mean, there were hospitals just full of people who were either psychotic or had a major depression, or essentially dysfunctional because of mental illness because we had essentially no effective treatment for them. And it's a really different world today.

Obviously, there's still a lot of mental illness that's difficult to treat. Our drugs are not perfect; but just having options versus having no options in terms of treating severe mental illness, you know, it is night and day.

Bob and Jay, do you guys know that our father was on reserpine for hypertension in the '70's?

J: No.

R: Ah!

J: I didn't know that.

B: Is that the drug that caused him to go into a depression?

S: Yes!

B: Yes! I remember, that, I remember him being very, very, very depressed.

S: Yeah, and then he was taken off the drug and he got better.

R: Wow.

S: So, anecdotally, in his case ... and just to note, it's never really been proven in a quality study, in a really well controlled study; but that doesn't mean that there's evidence that it doesn't cause depression. It just was never really studied in a controlled way.

R: It sounded more like it was taken off the market, really, and replaced by better drugs before anybody had really ...

S: Well, let's move on to some news items. We're gonna start with a debate that occurred – was it just last week?

E: Yeah, yes it was!

S: Last week.

R: You were there!

S: You guys all have a chance to see it?

B: Yeah! It was awesome!

J: Fantastic!

E: See it? Oh! I live tweeted it!

B: Fantastic!

S: So, this was Intelligence Squared. They are a organization that runs, they run debates! That's what they do. They host debates which are supposed to be very respectful, and intellectually of high quality. And the debate was on, "Death is not final." That was the proposition; death is not final. On the pro side was Eben Alexander, the neurosurgeon and author of the book, "Proof of Heaven," that we've discussed before on the show. And Raymond Moody, who was the author of the book, "Life After Life," which was, really the first, this book was published in 1975. It was the first book to really document the near-death experiences. And I believe he coined that term in his book.

E: Yeah, he did.

S: Yeah. It's funny, because I read that book probably in the late '70's, or early '80's. So, thats like ancient history to me. I was actually, frankly, a little surprised the guy was still alive. (Rogues laugh). When I heard that he was speaking at the debate ...

R: (Disapproving) Steve...

S: I'm sorry!

(Jay laughs)

R: But, you know, how much more convincing would his argument have been if he wasn't.

(Rogues laugh)

S: Yeah, that's true!

E: Yeah, right?

S: That's true.

E: Here, joining us from the next life.

B: We concede.

S: No, obviously, that was 40 years ago, almost. But he's still very much alive and active. Actually, Raymond Moody was a very nice guy. And backstage, in the green room, he was very complimentary. He said he listens to the show. He loves the SGU. And I could tell he meant it! He wasn't just BS'ing, because one of the conversation, he's a philosopher of logic, you know. He just has this one, apparently, sacred cow of near-death experiences.

And then, against the proposition, of course, was me, but also Sean Carroll, the physicist.

R: I love Sean.

S: Yeah, we've had him on the show before.

B: He's awesome.

S: Yeah, he was great. He was great. Yeah. So, I was in the debate, so I'm hardly an objective observer, so you guys gotta tell me what you think.

R: Well, you won.

S: We did win.

(Evan laughs)

R: So (inaudible) that.

S: Objectively

B: Surprised! Were you guys surprised at the win at this? I just assumed that they would lose, because just so many people are just so invested in that belief, and place so much importance on it. So, I was very pleasantly surprised that you had such a big sway.

J: Well, if you paid attention, Bob, if you paid attention (Bob laughs) you'd notice that the real swing here was with the people that were undecided.

R: That's not true, actually. First, to Bob's point. I was not surprised. I was actually surprised in the other direction, where I, because Intelligence Squared tends to attract, I don't know, a pretty smart crowd. And not to say that smart people can't, you know, can't believe that there's life after death, but they tend to be, I feel, a pretty skeptical crowd.

But, that said, in response to Jay, Sean Carrol actually did a wrap up after the debate, and he said the same thing. It looks like we moved over a lot of the undecideds, because when you looked at the final numbers, the For group gained a few, and of course, Steve and Sean gained more. So it did look like they were undecideds; but because Intelligence Squared I guess does it by, I think they do it electronically, so, they were able to tell who changed their votes from what to what. And ...

B: Wow! Cool!

R: So Steve and Sean actually got about the same number of undecideds as the other team; they were about split. And the, so the winning group came from the people who had been "For" the motion.

B: That is amazing!

R: Yeah.

E: And how does, and so the listeners know how this is designed is the audience votes before the debate their opinion on the matter, for, against, or don't know. And then they're asked after the debate to go ahead and cast another vote. And we see how they changed.

B: You know, guys, tell me if you agree. I thought the moderator did a fantastic job. Specifically, there are certain which often moderators will fail to do, is when somebody makes a contention or a point, and then they go to the other side to address it, then he was very good at crystallizing and stopping the discussion, and going back to the other group, saying, "Okay, this is what you said. There is his response. Now, what do you say to that?"

He really kept the debate moving forward and progressing it. And there were very specific instances where he did that very well, I thought.

R: Yeah, definitely. I felt the same. He also made me laugh out loud when he turned from the pro side to the anti side and said, "So, we're talking about ghosts now."

S: Yeah. Yeah, yeah.

E: Right.

R: I laughed so hard! That was great.

J: I also do like the idea that he will reject a question

B: Yes!

J: for varying reasons.

E: From the audience.

J: You know, one reason would be, it would take too long to answer it, or it had already been covered, or it just wasn't relevant!

E: It wasn't germane.

S: Wasn't on point, yeah. Yeah, so that was because the show was ultimately gonna be a podcast and a live broadcast. We're at the end of recorded broadcast, so they were editing out questions from the audience that weren't relevant to the discussion.

B: Yeah.

S: Which is a good idea. They coached us pretty well beforehand too. So, he told us he was gonna do that; he told us that if one side asks you a question, and I don't feel you answer it, I'll keep pushing you, and force you to give an answer.

B: Good, very good.

S: Which he did do a couple of times as well. Like, when I pointed out to Eben Alexander that he doesn't know when his memories of these experiences formed. He doesn't know. He says it was when his brain wasn't working. He can't possibly know that. That's kind of the crux of my criticism of NDE as evidence for extra corporeal sentience.

B: Oh it's critical! Absolutely critical!

S: Yeah, it's like, yeah! You don't know when those memories formed. There's a long period by definition of recovery and your brain could have certainly been forming those experiences and memories then. Then it tries to make sense of these disjointed, poorly formed, poorly constructed experiences later, and then it creates a narrative out of that. And, oh! Surprise, surprise, the narrative is right along with your culture, your beliefs, your religion. You know, it's not like you have Christians have a near death experience, and in it, they learn that Buddhism is actually the correct religion.

I mean, that never ... it's always perfectly in line with whatever their culture predisposition is. But anyway, so that's kind of the critical point. And I was happy that he forced that issue. And Eben really had no answer for it. He really didn't have any comeback for that.

E: To me, that was the surprising part of this debate is that I thought that we were gonna get more from the opposing side, frankly. I expected a little more. I think I over-estimated these gentlemen. I did not read their books, but I was hoping that this kind of forum would bring out their A-game. And I felt that they just didn't bring it.

R: Aija, what did you think of the debate?

AM: Well, I thought that the debate was interesting because of the vote before and after. So, they gave then a chance of kind of express their opinion and how they felt after. I did find some of the ... I can't remember the name of him, but the gentleman that had the personal experience, and he was just arguing from what he had seen, apparently.

S: That was Eben Alexander. Eben Alexander.

AM: Yeah. And it just seemed it was all completely based on what he had gone through, as opposed to any kind of actual evidence. And it was interesting that he's so

E: Right, it was a testimony!

AM: into what he had experienced, and kind of just ignored everything else. And he did mention the talk that he once felt one way, and he's now changed to the feelings that he has now, so it's interesting what a personal experience can do to someone.

S: Well, that's the story he's telling, anyway.

AM: Yeah, well, exactly.

S: Which he he admits evolved over weeks and months after this all happened. You know.

R: I believe that though. You know, just because, I think a smart person can suddenly change their mind when something that drastic happens. You know, even if he hadn't had a near-death experience, a quote-unquote, "near-death experience," he actually had a near-death experience. You know, he did almost die.

J: Right.

R: And, going through something tragic like that can really change a person, and change their thought process, and make them, particularly, I think, make them start believing something that brings them great comfort.

S: Yeah, my sense was that he was sincere. But it doesn't change the nature of the evidence that he was providing, though.

R: Yeah.

J: I don't doubt that he had a profound experience, even though it was happening in his own head.

AM: Absolutely.

J: It still was Earth shattering to him, and I can understand why someone could be moved to that degree. It's just frustrating as a critical thinker and a skeptic and a science educator that he did such a 180, and then did so much quote-unquote "damage," right? By misinforming people, and telling people exactly what they want to hear. Hey, this doctor, this smart doctor / scientist guy is now saying there's an afterlife, and giving proof, quote-unquote "proof." It's a little infuriating. To add, man, when he misquoted Carl Sagan, I got, I got visceral!

(Rogues laugh)

R: So did Steve! (Laughs)

B: Well, as much as Steve can get visceral.

R: Yeah, well I saw steam rising from his head.

E: The internet almost exploded.

J: What's funny is I'm in my living room, and I'm sitting there with my wife, and my sister in-law, and I'm just freaking out when he said that. And then I literally go up to the TV, I'm like, "Come on, Steve! Come on! Steve! Come on!" Like, I'm telling Steve, "Damn it man! Say something about this!"

E: And he did!

R: He did.

S: Well, so Eben said that Carl Sagan wrote in The Demon-Haunted World that the evidence for childhood reincarnation was overwhelming. Which, of course, he never said that. What he actually wrote was, he was talking about things that maybe would be interesting to do some further investigation. And he mentioned children who recount stories of past lives as one of those things. But he said he thought it was unlikely and that the evidence was dubious. So, Eben turned "unlikely" and "dubious" into "overwhelming."

R: Yeah.

AM: Yeah, that's insane.

R: I can actually picture Carl Sagan smacking himself on the forehead.

(Laughter)

J: Well, you just have to read the next sentence.

S: Right. But this is, again, the internet age. So, of course, the internet erupted.

R: Yeah.

E: Oh, yeah.

S: I think it took literally, like, one minute for there to be a picture of the relevant page of A Demon Haunted World on Twitter.

R: Speaking of the speed of the internet, my favorite meme to come out was a graphic of Sean Carroll quoting Scott Aaronson saying, "Quantum mechanics is confusing, and consciousness is confusing; so maybe they're the same."

(Rogues laugh)

E: Yes. Yeah, he did.

R: So amazing.

S: After the debate, backstage, you know, I was chatting briefly with Eben again. He looked at me. He goes, "Have you ever read the Demon Haunted World?"

(Rogues laugh)

R: So, apparently, he's just not a good listener.

B: Oh my gosh!

R: He's just not good at paying attention. Because you literally said, "I've read that a hundred times," during the debate.

S: Yeah. I don't think he just didn't hear me, I think. Yeah, in the moment.

E: He didn't hear you what with the dozen people applauding his use of the Carl Sagan, or misuse of the Carl Sagan quote there.

B: Did you guys notice when the moderator was mentioning, talking, introducing Steve and saying, giving all his achievements, and he mentioned, "And the New England Skeptical Society." And everyone laughed! Literally, you could hear, some, a lot of chuckling in the audience just because, the name of it, the New England Skeptical Society. I thought that was funny.

S: You're gonna tell us about a recent lawsuit of the company that makes the Five Fingered shoes.

E: Yeah, so, I don't know if you've, have we talked about the five fingered shoes before?

S: I don't think so.

E: I don't think so, and, you know, being active in the martial arts, I've actually seen people wearing these in our martial arts studio. So it's not something I'm unfamiliar with. I've seen people wearing these things. They're basically gloves for your feet. Right? They're light; they have little holes for your toes; and it kind of fits snugly yet comfortably on your feet.

And, you know, that's fine, and all. But when you're gonna go ahead, and you make and sell these things, and you're gonna start to name some specific health claims about the benefits of wearing these things, be careful because you may find yourself having to settle for millions of dollars in a class action lawsuit over false advertising, which is exactly what has happened here.

The name of the company is Vibram, V-I-B-R-A-M. They are the makers of the FiveFingers running shoes. And ...

S: Well, it says ...

E: they've settled out of court.

S: barefoot running shoes. Isn't that an oxymoron?

E: It is and oxymoron. I don't understand that. I think ...

R: The whole point of them is meant to mimic ...

B: Replicate, yeah.

R: Yeah.

E: Right, like you're not wearing anything at all. Wear it. But you actually are. (Chuckles) They have settled a $3.75 million dollar class action lawsuit. And, again, it was over false advertising, which is the key here as to ... it's important as to why they've had to pay! And they've had to basically admit that no! There are no health benefits to, they were claiming!

E: Yeah, yeah, they always do, but at the same time, then why are you settling, you know, for, for ...

B: You can't really use that as a ... people settle all the time. Just do it to save court costs, and a myriad of reasons. You can't automatically conclude that, "Oh! Since they settled, they must be guilty." Not necessarily, but in this case, clearly, it seemed to me anyway that there was some serious misdirection going on, and all that stuff.

S: But what often happens is, the lawyers are happy to take a settlement, and the company will say, "Okay, we'll give you $3.75 million dollars, but we want to be able to say that we did nothing wrong," and the lawyers don't care, because they just want their money, right? And their clients want their money. And having the company admit that they lied is negotiable, you know?

E: Well, part of this lawsuit though, is they're not allowed to make claims any more about these things.

S: Well, sure, of course.

E: Right? So ...

S: Well, they stepped over that line, you know? How many devices and products and whatever are on the market there where the companies are just careful about the kind of claims that they make. They'll say, "You'll feel invigorated," whatever, you know. They can say, they could make all kinds of statements that are just implying claims. But they've stepped over the line and made specific health claims, and that's where they got into trouble.

But what's amazing is how often that happens, and companies don't get into trouble. And I think ...

E: Yes.

S: I think, you know, it would probably would be a good thing if we start to see more of these class action lawsuits because I think there's probably hundreds of them out there ripe for the picking.

E: Let's see, homeopathy, maybe? Where are the class action lawsuits against these homeopaths?

S: Absolutely.

R: Or even every other shoe company because I've been really disappointed in the coverage of this in the media because I see a lot of headlines that are like, "Five Finger Shoes are Total Bunk," you know, or what have you. And the thing is, these are hideous shoes that make you look like a total loser when you wear them around. And I have lots of friends who wear them, and even they, they know this, they accept it, it's fine.

But because of that, I think people are more than happy to sort of pile on. And I think the facts kind of get lost. And so, what's been sort of spreading, the message that's been spreading is like, "These are, this shoe company has been claiming that, you know, running in this way is good for you. And it's total BS, don't believe it. Go buy these other shoes." Which isn't really correct.

The truth, I think, from everything that I've read, being a runner who hangs out with a bunch of runners, is that if you run in a very particular way, mainly by not landing on your heel, these shoes could be great for you. If you don't run in the way that these shoes are good for, then these shoes are gonna be terrible for you. And that is something that the company was not putting out there enough. They were making stupid claims about how these shoes would be great for anybody, when they're not.

But the problem is, the media's swinging it back in the other direction and being like, "No, all other shoes are fine. Those are the shoes that you should be using for running," when in fact, no. If you're a runner, if you want to take up running, go and talk to some one who is a professional, who can look at your gait, who can figure out the right shoe for you because it's a complicated issue. It's not just "This shoe is bunk, and this shoe isn't."

S: They're claiming specifically that it would improve your posture, strengthen your muscles, and reduce injuries. That "reducing injuries" is always one that gets people in trouble.

R: Yeah, because, and this is where the gait comes up. It'll reduce injuries if you have the very particular gait that these shoes are good for, if you do not land on your heel. If you land on your heel, these are the worst possible shoes for you. There's no padding. There's no spring on the heels. So you're effed; you will be injured.

J: I own a pair, by the way. You know, they're, everything Rebecca said, you know, just from a subjective level. They're weird, they look weird. I really don't like having something be between my little toe and the next toe.

B: Yes! Yes, graphene, we have talked about it. But, and it is pretty epic on so many levels. But scientists have recently discovered that, in addition to its already impressive resumé, we could now add that it can conduct an almost unlimited amount of heat, which actually directly contravenes a known law of material science. So it's really interesting.

So, yeah, you have heard that graphene does indeed break the law. But the details are pretty fascinating. Now, graphene is an allotrope of carbon, meaning that it's, merely that it's a different form of an element. In this case, the element of life as we know it, carbon, but there's lots of allotropes of carbon. Diamond is another one, probably more well known.

It consists of a one atom layer thick arrangement of the atoms in a hexagonal pattern, like chicken wire. If you can imagine chicken wire, that's exactly how the atoms are arranged. Since its discovery in 2004, it's been found as it was theorized decades earlier to have an amazing suite of properties, including strength beyond diamond. For this case specifically, if you can imagine a sheet of graphene as thick as cellophane, which is actually pretty thick as far as graphene goes, but it's still very thin. An elephant can actually be supported on graphene that is as thick as cellophane. So that is pretty impressive. That's what I've read anyway. I haven't actually done a demonstration of that, but it seems likely.

It also conducts electricity a hundred times better than silicon, and a thousand times better than copper. It's transparent; it's bendable. And that's just the tip of the iceberg.

Now, the application of this material in a myriad of near-term objects from electronics to bulletproof vests literally have scientists and non-scientists almost watering at the mouth. I mean, it's just so compelling. It's even more awesomer than all that. That's a word, right, Rebecca?

R: Sure, why not?

B: Okay. So, recent experiments show that it can conduct essentially an unlimited amount of heat. So, that's the crux of this latest news. And, so, basically, if you tested its heat conduction, and you measured, say, X amount of heat per unit of time, and then you made the sample of graphene just a little bit bigger, it would then logarithmically increase the amount of heat it could conduct. Very, very amazing.

And that's because of Fourier's law of thermal heat conduction. Now, this law says that, in part, it says that the materials' size or shape should have no impact at all on the rate of heat transfer per unit size of the material. So, it shouldn't make any difference.

So, thermoconductivity is an invariant aspect of any material – a constant – and they've never seen an exception to this law until graphene, of course. Now, ultimately, though, this isn't really just a magical feature of just graphene. The researchers believe that this new behavior is essentially an outgrowth of the fact that it's essentially a 2-dimensional structure, and it's chemical bonds are very, very stiff. And for some reason, those kind of work together to produce this amazing effect that it has with heat.

Now that we've entered material science, that's essentially 2-dimensional, we're seeing this amazing stuff that's gonna have some amazing materials applications. So then, the upside, then for this discovery is that graphene could be an amazing boon for electronics just based on the way that it handles heat alone, not even mentioning all these other amazing properties.

So heat, I don't think we've talked about this much on the show, but heat is the bane of electronics. It's really an incredible problem for modern electronics. Getting rid of heat is one of the key stumbling blocks that we're facing now with all these faster and denser electronic components.

S: Do you think, Bob, that a, essentially, a computer chip that incorporates graphene is, are we anywhere close to that? Because that would seem the obvious application. You have a substance that is really highly conductive, and, you know, it can be used to make a semiconductor, or whatever we need to for a good processor. And also, would be essentially self-cooling because it will wake away the heat.

B: Exactly! And that's one of the major benefits of this heat conducting, the capability. It can cool itself! Right. Which is amazing. So, I think, yeah, I've read comparisons to silicon, and it's better than silicone in many different ways, or silicon in lots of different ways. So, I think, yeah, I think, I'm not sure, I don't know what the cutting edge is in terms of turning graphene into all the components necessary for computer chips. But I think that it's definitely a possibility. And I think that may be one of the initial applications we see. Hopefully, in 5, 10 years, who knows?

S: Rebecca, far and away, the most common item we've had emailed to us over the last week was this new website that sheds some light, perhaps on correlation and causation.

R: So, yeah. This, I really love this. It's a site called, "Spurious Correlations," by Tyler Vigan – Vygan? Maybe? T-Y-L-E-R V-I-G-E-N dot com. He wrote an algorithm, basically, that searches through statistics from the U.S. Census, and the CDC. And it takes that data, and finds things that have correlations, and then charts them. So, a random one would be, the number of people who drowned by falling into a swimming pool, which correlates with the number of films Nicolas Cage has appeared in.

Or, the per capita consumption of cheese in the U.S., which correlates to the number of people who died by becoming tangled in their bed sheets. And it's brilliant. He's got the stats for each year beneath each graph, and he lists how close the correlation is. It's brilliant.

And it's a nice way, a nice, easy way to point people in that direction if they have trouble understanding that correlation does not equal causation, which is kind of a basic sort of logical fallacy that we talk about all the time on here, but can be really convincing. For instance, it's one of the reasons why we think that people suspect that vaccines cause autism. Because children tend to be diagnosed with autism around the same age that they get a bunch of vaccines; just after they get a bunch of vaccines.

So, people put the two together; there's a correlation there; they assume that there must be a causation, that vaccines must have caused the autism. But, of course, correlation does not mean causation. So, yeah. This is a really good site to point people to, to say, you know, just because the divorce rate in Maine has been decreasing as has been the per capita consumption of margarine in the U.S., it does not mean that more pe – less, fewer people are getting divorced in Maine because they're not eating margarine any more.

E: But it might.

R: But it might.

(Rogues laugh)

S: Probably not. Yeah, I like the one, when I wrote about it, I used the U.S. spending on science, space, and technology correlates with suicides by hanging, strangulation, and suffocation.

R: Right.

AM: Wow!

S: And the beautiful thing is, it's not just like, there's a linear relationship, they're both going up. These are curves that are like tracking with each other over a long period of time. They're really, the ones we are picking out are cherry picking, obviously, out of the countless possible correlations. They really track well, and you just look at that chart, it would seem entirely compelling that there's a real correlation there. But, yeah.

R: Yeah, some of them are more in line than others. And that's why he's got the correlation listed. But, yeah. Some of them are just astoundingly similar to a scary degree.

S: If you have large data sets, and you are looking for any possible correlation, you'll find them. And you'll find them that they seem stunning. Which is why whenever we use correlational, observational data, I mean, obviously sometimes correlation is causation. It's just not necessarily so. But the first question you always have to ask yourself, "Is the correlation real?"

Before I try to explain the correlation, etcetera, let's just first find out if it's real. And when you find a correlation that involved any kind of data mining, then you have to verify it by looking at an independent set of data to see if it continues to be true with fresh data. Otherwise, don't even waste your time speculating about what's causing it, because it's, you haven't even established yet that the correlation's real. Yeah, so I think it's, it's a great site for driving home this one lesson.

S: Aija, you, we were asking what you wanted to talk about. You said that you want to talk about lab-grown vaginas.

AM: Absolutely.

R: Who doesn't?

(Aija laughs)

E: Good choice.

S: Or, as we've been calling them, fauxginas.

AM: Fauxginas. (Laughs) I think "engineered vagina" would be better, or more appropriate.

S: Engineer?

B: I like that one.

AM: That's what they're quoting here in the article that was sent to me a couple weeks ago.

S: You're getting Bob excited.

(Bob laughs)

AM: It's actually pretty exciting what they were able to do. I'm pretty amazed. So The Verge posted an article that somewhere between 2005 and 2008, that they grew four vaginas in a laboratory that were successfully implanted into these women. And it is now, geez, it's about an 8, 9 year period since they've had it done. And they are functioning, and working, just like a regular vagina! And the patients, they've decided to ...

R: That's awesome.

AM: Yeah. That's amazing. I didn't realize that people would need a vagina made for them, but there's apparently a disease called - it's a fancy one – Mayer-Rokitansky-Kuster-Hauser syndrome. And it's shortened for MRKH. And it causes about 1 in 4500 girls to be born with either an undeveloped, or an absent vagina.

S: Yeah, they essentially don't develop their Müllerian duct; this is early on in development, organ development. And so, they don't get a uterus, or a vagina, and they can also have kidney malformations, and other problems as well. But they can have ovaries. And they can have normal – otherwise – secondary sexual development and characteristics. And they're genetically normal.

So, we actually don't know what causes it. Most cases are sporadic, meaning there's no family history. And, we don't know what is going wrong in the developmental pathway that results in this suite of problems. Although, there are, I discovered, there are some people who do have an apparently autosomal dominant inheritance pattern. Meaning that it appears to be genetic in some families, and you inherit it ... each generation gets it. It's a dominant inheritance pattern.

Yeah, and prior to this, the fix has been surgical. You make a vagina surgically, and then they were lining it with either skin or intestines. So, this seems like a better option.

J: But, guys, when you say vagina, are you talking just about the outer portion, or the entire organ?

R: Well, there's no outer portion of the vagina.

J: You know what I mean.

AM: That's correct.

S: The labia?

J: Explain it to me in layman's terms.

AM: So, the inside is what they're recreating.

J: Right, but is it just, what part of the vagina? And I hate to sound ignorant about it, but what part are we talking about?

AM: According to the MRI image that they're just missing the interior. And, really where cases are missing part of the exterior, which they can recreate using surgery.

S: So, sometimes, Jay, girls discover that they have this problem, because they just fail to menstruate. So, just from the outside, everything looks fine, but then they never menstruate, and so they get an examination, MRI, whatever, and they realize that things are underdeveloped on the inside.

So, one thing I'm curious about, which I couldn't find any detailed information on this; they say that the vaginas that are surgically implanted from the lab-grown cells, that they're functioning normally. And that includes by the report of these four patients, normal sexual function. Which, operationally, they said that means pain-free intercourse, which is great, although that's kind of a low bar if you know what I mean, just that it's pain free. But my specific question is I wonder how much sensation they get, if any. You know, that, which wasn't directly addressed in anything that I read.

AM: I would definitely think it would be more functional than what's provided for say, a transgender person. Because they're just given a canal that they have to dilate and keep open for about a month, and then they have, you know, this hole that's kind of like a vagina. I wonder if they would be able to transfer that to somebody who's transgender? But, they're using skin cells, and it's about the size of ... I believe they quote half a stamp. Then they grow them in the chamber.

S: So, specifically, they take vulvar tissue. So, it's not like, just like, regular skin. So, they're trying to get as close as they can to the kind of epithelial cells that you have in a vagina. But it's, yeah, they scaffold the muscle cells, and the uptheleal cells as two separate layers so that it mimics the actual anatomy of a natural vagina. So, it's actually pretty sophisticated.

AM: Yeah, there's some scaffolding involved as well, and they use that to kind of have a base to be able to implant it.

E: Do you guys know what the scientists exclaimed when they realized their research panned out?

S: Not really.

AM: No idea.

E: Urethra! (Aija laughs) Thank you Aija; I knew you'd laugh.

R: Urethra?

E: (Laughs) Yes?

R: I mean, the urethra is ...

S: Separate.

R: separate from the vagina. That's about ...

AM: I'm willing to go with the joke just because they quote about inserting the urethras in boys.

E: Different house, same neighborhood. Thank you.

R: You know that girls don't pee through their vagina, right? Because actually, this is something that came up recently. There was a Reddit thread on the women's subreddit, Two X Chromosomes, where they were like, "What's the dumbest thing a guy has ever said to you?" And a shocking number of people reported men not knowing that women have separate holes for peeing and for their vaginas. Like, they did not realize. And like, I'm talking adult men, in their 20's and 30's. So ...

S: Well, Evan, it's that time of the show again where you get us up to date on Who's That Noisy?

E: Yep. Yep, this one you had a couple weeks to ponder and make guesses on. So, I'll go ahead and play it for you again, so, you are reminded. Here we go:

?: (Man's voice) The sexist thing in the entire world is being really smart.

??: (Another male voice) I haven't seen you my whole life, and now you come back and just expect a relationship? I hate you.

???: (3rd male voice) So first, a group of tiny creatures. Among the first lifeforms on Earth. Bacteria; responsible for keeping our own ecosystem checking over, but when they attack us, it's an ugly sight.

E: Alright, so the audience had the task of, first of all, naming those three voices. So, this is kind of a puzzle and a Noisy all wrapped in one. And then you had to go through the process and figure out what in the world of science and skepticism do the three of these people have in common?

Okay, so, they were, in order, Ashton Kutcher, from his now famous MTV award speech; Seth Green from his part in the first Austin Powers movie; and Dara Ó Briain, who runs the show, who has a show about, you know, science and things related to science. One of several shows that he's on. But we know him to be a popularizer of science as well.

Those are the three names. Lots of people got those correct. But only a few, select few, were able to figure out that the thing that these people have in common – they're all actors, comedians, whatnot – but that has nothing per se to do with science or skepticism. But, the three of them have all taken a ride on the ...

E: Also known as reduced gravity aircraft. And, what it does, is it gives the occupants the sensation of weightlessness by following a parabolic arch. And you get a sense of weightlessness.

B: I want to do that so badly. Oh, god. I wouldn't hesitate.

S: So, do it!

E: You think you will?

S: Can't you just pay for it?

J: I think you can.

B: I don't know.

E: I believe that you can. I don't have those details, but they must be out there and available.

S: Bob, do it, report back to us.

B: Okay, will do.

E: Yeah, bring back whatever you throw up. So, we can see, you can prove it to us. Like I said, there were a couple of people who actually got this one correct. This was not an easy one, but well done. This week's winner, Robert Dalstrum. Robert Dalstrum, well done! Very well done, Robert. Congratulations.

S: What have we got for this week, Evan?

E: Here were go: Who's That Noisy?

(Bleating goat or something sounding angry or strained)

B: I don't know what it is, but it's weird and pissed off.

(Rogues laugh)

E: I would agree with that description. Alright, so, if there are some people familiar with this particular ...

S: Noisy

E: Creature, making this noise, I think they'll have a good advantage. But, for other people, just go ahead! Give it your best guess! Whatever you think it is. Funny, ridiculous, outlandish, alien, I don't care! Send us a guess. And you can email that to us: WTN@theskepticsguide.org As I say every week. Good luck, everyone.

S: Yeah, so, we always like to point out that you were our first guest on the SGU. You have that honor that no one else can ever take away from you.

MP: It's one of my most treasured ones.

(Jay laughs)

S: I'm sure.

R: That's sad.

(Rogues laugh)

S: So, Massimo, we asked you to come on the show because we're gonna talk about one of the more common items that our listeners emailed us this week asking us to discuss. We're just getting to the end of the new Cosmos reboot, and I loved it. I think everyone is ...

B: Oh yeah

S: is very fond of it. And Neil deGrasse Tyson, definitely an excellent science communicator. I think he did an excellent job. But during a recent interview, he said some interesting things about the relationship between philosophy and science. And who better to comment on this than our friend Massimo, a philosopher and scientist. So, what do you think? What did he say?

MP: You know, so this was actually the latest episode of Neil getting himself into trouble with that. And as you probably know, he's not the only scientist, and especially the only physicist, really, in recent years to do so. But, he was on a podcast, and he was joking around, and all that. So, to some extent, there was also some kind of light-hearted comment.

But, nonetheless, at some point, somehow, the topic of philosophy came up. And he said, basically, that philosophy, and I almost quote directly, verbatim, can really mess you up, and that he would not suggest that a bright undergraduate student to go into philosophy. And I said, "Whoa! Wait a minute! Why is Neil saying that?"

And then he went on, basically deploying the same, it's sort of become a standard thing among some physicists, the idea that, well, philosophy is really not particularly ... it's dead, or it's not particularly useful, because, after all, it hasn't been done anything to advance physics over the last sort of a hundred years or so.

Now, I actually, produced a transcript for the podcast, for that segment of the podcast. Then I went back, and actually, I checked several other quotes that are available around from Neil about on the same topic. And I finally sit down, and I wrote a long, I think, balanced and constructive essay for my sort of, new webzine Scientia Salon. And I sent it to Neil.

I said, "Look, we know each other. You've been on my podcast for a couple times. And, you know, and I think I owe you to send you this ahead of time. I think it is constructive and respectful, but nonetheless, I'd like your feedback on it. And if you want, of course, you can respond to it."

So, we engaged into a correspondence for three or four days before the essay was published. It was published this past Monday. And Neil was very nice, and repeated several times that I had not misconstrued what he said; that I didn't understand precisely his meaning, so there was no straw manning around, and all that sort of stuff. But, nevertheless, he didn't really concede much of a point, and it was a little bit frustrating frankly, because what I told him, he really didn't understand what the big deal was.

And I said, "Well, the big deal is that you are a brilliant science communicator; and you have a large audience; you reach people, many of whom are bright, young, kids who are gonna go and might go in high school, or college, or are gonna go into science or maybe, in fact, going into philosophy. And these are people who respect your opinion as a public intellectual. So, if you go around saying that an entire field of inquiry is useless, and hasn't done anything over the last hundred years, you know, people will pay attention. You're causing real damage, and I think, with great power comes great responsibility."

S: I've heard that once.

MP: (Laughs) Yes, I didn't come up with that one.

S: But he didn't move. Basically, he said that, "You're being fair to my position, which is that I don't think philosophy is useful."

MP: Yeah, so he qualified that, and in fact, it's quite a qualification, first of all, because one of the problems when people, especially physicists, I noticed, talk about philosophy, they don't really mean philosophy. They mean philosophy of science. Because, he said, "You know, well, there's plenty of areas in philosophy where philosophers have a lot, lots of things to do, like, to say, for instance, in ethics and epistemology."

And I said, "Okay, so your beef, really, is with philosophy of science." And so he agreed that that's, yes, that's the situation. I said, "But, okay, the problem, however, is that there are two things that are incorrect with your statement that philosophy of science hasn't done anything for physics over the last hundred years. The first, and bigger problem is that that is not the point of philosophy of science. Philosophy of science usually – and there is an exception, I'll get to that in a minute – it's not in the business of solving scientific problems. We've got science for that!" And it does a very good job!

So, you know, philosophy, the way to think of philosophy of science is similar to the way we should think about, let's say, history of science, or sociology of science. These are, all three of them are fields that look at science from the outside, and trying to understand how science works; and occasionally even engage in some kind of science criticism, but from the outside.

The difference among those three, of course, is that history of science looks at the historical developments in science, the things, you know, the dead ends as well as the things that work out, and why they worked out. Sociology of science looks at science as a social enterprise; after all, scientists are human beings. They interact with each other in certain ways. They observe, of course, the influence by the external cultural milieu within which they live.

And then, philosophy of science looks at it from the epistemic perspective, that is, the logic of scientific discovery. The logic of individual scientific theories, and the relationship between data and theory, that sort of stuff.

So, just in the same way in which you would presumably not complain about sociology of science or history of science, because they haven't contributed to solve any scientific problem over the last hundred years, you shouldn't really complain about philosophy of science for the same reason.

S: Yeah.

MP: Now, there is an exception to that pattern, and that's my, the second reason I think Neil is wrong. And that is, there is a small subset of philosophy of science where philosophers really get into collaborations with scientists in biology, in physics, in specific areas of physics like quantum mechanics or string theory and so on; and those are areas where the philosophers develop an in depth sort of analysis and criticism of certain concepts within those disciplines. And that conception analysis comes really close to being theoretical science.

So there's a borderline there, there is a porous border between conceptual analysis in philosophy of science and actual, theoretical science; so much so, that if you actually look at some of the papers that are published in those areas, it's hard to tell whether the author is a philosopher or a scientist; and, in fact, sometimes they're both, meaning that they're collaborations.

And, so I told Neil, I said, "In that case, you are factually wrong, because actually, there is quite a bit of philosophy of science that has contributed to both physics and biology. And examples include papers on the different interpretations of quantum mechanics, papers on the epistemic status of string theory, and fundamental theories of everything, or, in biology, there's a rich literature on species concepts. Or, for instance, on methodologies for reconstructing phylogenetic trees, that sort of stuff.

So, these things are actually documentable, and I said, "You know, I can send you lots of papers that actually show that there is quite a bit of active scholarship about it; and so, you are, in fact, factually incorrect when you say that there hasn't been any contribution." Now, if you expect, however, philosophers to solve major, big thing, like coming up with the idea of a Higgs boson, then you're barking up the wrong tree, because that's not their job.

S: So, if I could summarize a little bit of that, theoretical scientists are doing, their activity's very similar to philosophy. And sometimes, philosophers are informed by empirical processes, and they kind of merge in the middle. So, there isn't really even a sharp demarcation between theoretical scientists and empirical philosophers.

MP: That's right. I think it's fair to say that there is a core component to theoretical science and discovering not philosophy, just like there is a core component of philosophy of science that is clearly not science. But then there are areas where the two grade into each other. And, by the way, some physicists are very well aware of it. Sean Carroll, for instance, criticized Neil recently for essentially the same reasons.

In fact, Carroll has just published an essay on his blog, late last week, I think, where he was doing for what essentially amounts to a conception analysis or philosophical analysis of the differences between different interpretations of quantum mechanics. And he was, you know, wondering about whether at some point those different interpretations, which are at the moment, as my understanding is, don't trust me too much, because I'm a philosopher of biology, not of physics. But, my understanding at the moment those interpretations essentially don't make discernible, empirical predictions. That is, you can't tell an interpretation of quantum mechanics from another.

But, Sean was saying, "Maybe, at some point, they will. And it will be interesting to see." And he was sort of nudging things in that direction. Essentially, he was doing philosophy of science. He was doing a conception analysis of a scientific theory.

S: So, I'm trying to figure out why so many physicists have a problem with the philosophy of science. And, you know, just relating it a little bit to my own field of neuroscience, I certainly feel that there are some philosophers of mind, which is another kind of philosophy of science. Get into, what might fairly be called philosophism, is that a word? Did I just make up a word?

MP: (Laughs) I think you just made up a word. But yes, fair enough.

S: Like scientism, but this is philosophism, where they are trying to answer scientific questions with philosophical methodology. Like, when they try to tell me that the materialist basis of neuroscience doesn't work because of some philosophical reason, which I think is BS. I think that they're over-reaching.

So, are they reacting to that sort of thing happening in physics? Or, are they just not, don't really have a basis for their reaction.

MP: That's a good question. I mean, it is fair to say that some philosophers do engage in philosophism, which I think is, again, fair to say. It's sort of the philosophical equivalent of scientism. You know, there's some bad philosophy being done, and there is some, or at least some questionable philosophy being done. I actually, philosopher of mind is a particularly egregious example.

There's a significantly higher number of instances that I can think of there than, let's say, in the philosophy of mathematics, or philosophy of physics, or philosophy of biology. Why that is? Well, probably because, I think you would agree that the science there is less mature. It's exploding – has been exploding for the last several years, but it's less mature than, let's say, quantum mechanics, or evolutionary biology, or that sort of stuff.

And that's a typical historical pattern, that is the balance between, at the borderline fields, the balance between science and philosophy tends to lean toward the philosophy when the science is young or still immature. And then it shifts over to the sciences when sciences do mature. So, I think that's a fair issue. Then again, there's also a lot of bad science, as I'm sure you know.

S: Yeah.

MP: On the other side of the divide, so it's not very useful to start counting, "Well, here's this many philosophers they're saying crap." Well, yes, there's all sorts of scientists saying crap, and there is, that's the name of the game in academia. A lot of people write things that then later become questionable, or, at face value, sort of very bizarre.

In the case of physicists though, I think the reason is different because I don't see as many cases of that sort of phenomenon that you were describing happening in philosophy of physics. In fact, philosophers of physics, as far as I can tell, have very solid grounding in physicists, and they're really serious contributors to the field.

So, I think that what it is, is just this generic attitude and sort of, essentially, misunderstanding, sort of cartoonish version of philosophy. And, I can tell, you know, with Neil was very illuminating, actually, to have these conversations because at some point, he said, "Well, look, I don't have a problem with philosophers like Popper who essentially described what scientists do and mostly talked to the general public."

And I said, "Neil, wait! That's not at all what Popper was doing! Popper was famous for being one of the most prescriptive philosophers in the history of the 20th century. I mean, he really was telling scientists what they ought to have done. It was definitely not descriptive.

So, I suspect that there is some kind of dismissal of something that, they have a cartoonish idea of. And it's fine with me if a scientist has a cartoonish idea of philosophy; that's not their job. It's a little less fine if that person is somebody with a broad, public audience at his command, and starts saying the kind of things that Neil has said.

And, by the way, I should say, all throughout these conversations with Neil, things have stayed cordial. And with gone with each others' arguments. But the whole thing was very cordial, I think as it should be.

S: Yeah, as I would expect. Alright, well, Massimo, we appreciate you coming on our show to explain all this for us.

MP: A pleasure as usual.

S: Yep. It's always a pleasure to talk to you about these kind of things. I always learn something.

MP: Thank you very much.

S: Yes, so, and we'll get you back on the show sometime soon.

MP: Absolutely! It'll be a pleasure.

S: Are you gonna make it to TAM this year?

MP: No, I'm not scheduled to make it to TAM because I have to work toward getting up for my new job. I was just offered a new position, and I'm moving to City College here in New York.

S: Oh, congratulations.

MP: Thank you, I'm gonna be in charge of directing their master program in history and philosophy of science. And, so it's gonna be an interesting summer for me to sort of transition from one thing to another. But, I do have a new book in the makings, so I'll let you know when it comes out.

S: Each week, I come up with three science news items or facts, two genuine, and one fictitious. Then I challenge my panel of skeptics to tell me which one they think is the fake. We have a theme this week.

J: Oh boy.

R: (Groans)

S: Let me tell you about the theme. So, last week, I was in Chicago. I was invited to be the keynote speaker for the Evidence Based Dentistry Conference.

E: Cool!

S: It's very cool, yeah! And, actually,

B: No it's not.

S: No, it was! There's two (inaudible)

E: Did you fill in for some one else? Get it? Fill in?

B: Oh my gosh.

S: Yeah. Yeah.

R: Okay.

S: Jason and Grant have a podcast, Prism Planet. Evan, you were on that, I think.

E: Yes, I was. They interviewed me.

S: They interviewed you for that.

E: Yeah, they're good guys.

S: So, they interviewed me as well when I was there. Yeah. So, you can listen to the episode. I was on episode 22. Go to Prism Podcast. So, I learned some things about dentistry that I thought was very interesting, and I've parleyed that into the Science or Fiction.

E: Oh boy.

S: We'll see how much you guys know about evidence based dentistry. Here we go:

R: Zero.

(Rogues laugh)

S: Item #1: There is no significant evidence that flossing reduces plaque, or the incidence of carries. Carries are cavities. Item #2: Antibiotic prophylaxis is no longer routinely recommended prior to dental procedures for those with heart murmurs, valve disease, or most other heart conditions. And item #3: Daily tooth brushing is associated with an increased risk of receding gums.

So, Aija, as our guest this week, you get to go first.

AM: See, this is interesting, because I've just gone through some interesting dental work. So, I'm not sure if I'm reading this all right. But it says, #1, there is no significant evidence that flossing reduces plaque, or the incidence of carries. I would think that it does, on the basis that my dentist had just told me...

Antibiotic – how do you even say that word? Prophesis ...

S: Prophylaxis.

AM: Okay.

B: Steve, do you wanna define prophylaxis? That's just doing it, just in case.

S: Yeah, prophylaxis

E: It's a condom.

S: is preventive therapy. Just like condoms, preventive. The idea here is that the recommendation was that if you have, say, a heart murmur, you would take antibiotics before you would get dental procedure, in order to prevent getting an infection of your heart valve. So, now this item is saying that's no longer the recommendation.

AM: Oh, that's so strange, because ... And then another one is, daily tooth brushing is associated with an increased risk of receding gums. And I'm gonna say that's definitely true. So it's a toss up between 1 and 2. I would have to say that 2 can't be true. That's my decision.

S: So, you're saying, so the antibiotic one is the fiction.

AM: Yeah, because, I would think that at least in Canada, I think that's a routine thing to provide antibiotic treatment before any kind of dental procedure.

S: Alright, Evan, since you were on the Prism Planet podcast, you get to go next.

(Jay laughs)

(Teasing laugh')

E: Thanks. Alright, no significant evidence that flossing reduces plaque, or the incidence of carries / cavities. Well, this would be surprising, maybe the most surprising of the three. We obviously are all raised by our dentist to floss, floss, floss, floss. Brush, brush, brush, and floss, floss, floss. But no significant evidence. So that means all the evidence leading up this has been wrong? And they've somehow misconstrued it? I don't quite understand that, and I'm holding out that that one might be the fiction.

So, I'll move on. The antibiotics. No longer routinely recommended prior to dental procedures. I had no idea that they were routinely recommended prior to dental procedures. I really did not know that. I obviously knew about the association.

B: Steve had to do it. Steve, you've done it in the past. I don't know about lately. I wish I did know.

E: Increased risk of receding gums. Maybe it has to, I'm thinking that this one is science. I think maybe it has to do with the how people ...

B: Ding! Ding! Ding! Ding! Ding!

E: brush their teeth. If you brush correctly, or do it in a certain way, then you won't have that risk. But, you know, if you do it haphazardly, or in an incorrect way, then yeah, you will have that risk.

So, therefore, that leaves me with the first one. Flossing reduces plaque, incidence of cavities. I'll say that that one is the fiction.

S: Okay, Bob.

B: Yeah, I'll start with 3. Yeah, that's exactly what I was thinking. That's it's more, it's how they do it. And if you do it right, you're not gonna have much of an increased risk. And, so what? Even if there is and increased risk, so what? Because, daily tooth brushing is so beneficial that that increased risk is well worth it. So that one make sense to me.

The other ones, especially 1, with the flossing, that's just really ... I'm suspecting here that there's something, there's some other major benefits of flossing that don't necessarily need to include plaque or the incidence of cavities. That makes that one work. But it's just too just blatant. Like, really? I mean, come on.

So, I think I'm gonna go with the antibiotic prophylaxis. I know, Steve, you had to do that. I guess I would believe that they did an assessment and realized that, no, it's not, it's really not doing anything. It's not really necessary. So, they're not doing it any more. So I could buy that one. So, I'm gonna say the antibiotic one's fiction.

S: Okay. Rebecca?

B: Ahhh...

(Laughter)

E: Bob?

R: That was a weird sound.

B: Yeah.

R: Was that the groan of regret?

S: Impromptu Who's That Noisy, Bob?

(Laughter)

E: Oh, good! Wait, I'm gonna write that down.

B: It's just, like, damn, I'm just not confident at all. Go ahead.

E: Bob moaning, okay.

R: Alright, the flossing one bums me out because it's so surprising that I feel like playing the psychological game. I feel like, that it might very well be true. And that bums me out, because I've been really, really good at flossing every day for most of this year. Maybe this is something like the way people usually floss? Like, maybe ...

B: Ah!

R: I've had dentists lecture me about how, the right and wrong way to floss. You've got to get in there.

AM: Yeah, me too.

R: So, maybe that's what this is about.

E: You don't see blood, you're not doing it right.

AM: Ow.

R: The daily tooth brushing one also weirds me out in a different way. And that's the whole set up of the question, I find very distressing, like, when you say "daily tooth brushing," does that imply once per day, Steve?

S: At least once per day.

R: At least. Okay. Alright. That's, I should have started with that question. Okay. (Evan laughs). So, yeah, increased risk, what does that mean? It could be a very slight increased risk that is heavily outweighed by the benefits of getting all that crap out of your teeth.

B: Good point.

R: So, I'm gonna, this is not my field of expertise; I'm gonna GWA this. I'm gonna go with Aija; I'm gonna say the antibiotic thing is the fiction. But I feel like people with valve disease and other heart conditions should probably get antibiotics. I feel like it would be more useful for them. So, I'm gonna go with that for the fiction.

S: Alright, now Jay, I deliberately had you go last, because you're the person who's obsessed with their oral hygiene.

J: Oh my god! Of course!

S: The most ...

J: Where do I begin? Okay, so first of all, the first one is absolutely and utterly wrong. Wait, let me read it again. There is no significant evidence. No, there is significant evidence that flossing reduces plaque. It's not directly, it's that it's dislodging the food particles in your teeth, which will turn into plaque, right? So, I don't think that the flossing process actually is having a huge, significant reduction in the plaque that you've already developed; it's future plaque.

And I mean, I've talked to my dentist about that one, like, every time. This one about the antibiotics; sorry guys, that one is absolutely science. They don't give you a, they do not give you antibiotics. Only if you have the absolute most severe heart conditions. All these other medium and low risk ones, no chance. You're not gonna get the antibiotics. And I happen to know that because I just asked my doctor about this recently. And I can say that because I'm going last.

(Evan laughs)

J: This last one, daily tooth brushing. God, this one has got to be the fiction because, for the most part, if you're brushing your teeth correctly, and this is where all these are really tricky, and I can find flaws in all of these. If you're brushing your teeth correctly, you will not have a reduction in your gums.

Gum disease actually makes your gums recede. Brushing too hard, and damaging your gums from flossing makes your, could make your gums recede. That's why you should use an electric toothbrush, and use a very light touch, even on the electric toothbrush. But an electronic toothbrush does, like, 10,000 times the work. Your teeth feel differently. I mean, I've, one day having to use a regular toothbrush – I forgot my electric toothbrush, bought a regular, manual toothbrush – and you could feel grime on your teeth. With the electric toothbrush, there is no ...

R: I actually agree with that. When I travel, I have to use a regular toothbrush, and I hate it.

E: Yeah, you might as well pick up a stick and start rubbing it all over the ...

J: So, I think #3, the one about brushing your teeth increases the receding gums; I think I have to say that one is the fiction.

S: (Groaning) Oohh

J: And I have more information. I could keep going, but I'm editing myself now.

E: Go ahead.

S: Alright, so, we have a good spread. So, Evan is for the flossing; Jay for the brushing; and everyone else for the antibiotics. So, I guess we could take these in order.

R: Uh oh.

(Laughter)

S: There is no significant evidence that flossing reduces plaque, or the incidence of carries. Evan, you think this one is the fiction.

E: Yes, I do.

S: And this one is ... science.

B: Wow. So, what is it?

S: There is ...

R: I'm bummed.

S: There's basically no compelling reason to floss.

R: What!

J: Steve, that's not true!

E: Now, hang on. That can't be right. (Crosstalk) You get food pockets.

(Crosstalk)

J: It's the food particles. That you have to get rid of that between your teeth.

R: Yeah, they're gross, and they smell, Steve.

E: And it can cause pain, actually.

S: Alright, so, systematic review, Evidence Based Dentistry's systematic review, and also, I had the dentist tell me this! I'm like, "Really? I don't have to floss? Okay, that's interesting." They looked at systematic reviews looking at three outcomes of gingivitis, plaque, and carries.

R: Just, ***king say "cavities," Steve. Stop talking like a dentist.

S: I'm reading! I'm reading.

R: What is a carry? Just say, "cavities."

S: Cavities, holes in your teeth.

R: Thank you.

(Evan laughs)

S: So, no evidence for – at all – for reducing cavities. They said that the evidence for reducing plaque was weak and very unreliable, There is evidence for reducing gingivitis, but ...

J: And bad breath.

S: but the effect is tiny. So, there was a small, but statistically significant effect, but the evidence, really, is still only moderate. There's some evidence, they said. So, you know, you could make a thin argument for flossing for the gingivitis thing.

J: Your, but your gums will adhere to your teeth. If you floss, you're making sure that there's a healthy separation between your gums ...

S: Yeah, but Jay, you're just stating assertions. I'm telling you about the evidence. Here's the thing: The bigger picture here is that dentists say a lot of things that are not evidence based. And the whole point of the Evidence Based Dentistry movement that these guys are innovating is actually basing recommendations on scientific evidence.

B: Well, what good is that?

(Evan laughs)

S: Because even more-so than for physicians, dentists tend to be in private practice by themselves. It's very technical, you know what I mean? It's much more independent. There's a lot more resistance to being evidence based, to having standards, and, you know what I mean? And a lot of what they learned is just they learned it in dentistry school; it's just the culture; they assume it's evidence based. When you really dig deep, the evidence base isn't there.

J: I'm having a skeptical moment, right now, okay?

S: Yeah, I was shocked.

J: Let me say, let me illustrate, real quick. This is important.

B: Holy crap.

J: I am suffering, I am in pain right now, thinking that my information is wrong. But I am very much open to hearing the new information. As much as I'm pissed off at all the people that gave me poor information.

S: Yeah.

J: I think I'm right! I still feel, in my heart, I know I'm (inaudible).

(Steve laughs)

B: What about bad breath, Steve?

E: Speaking of the heart ...

S: I didn't specifically, let me finish the items, and then I'll tell you what I think about that, okay? Alright, let's go on to #2. Antibiotic prophylaxis is no longer routinely recommended prior to dental procedures for those with heart murmurs, valve disease, or most other heart conditions. Jay, you think this one is science; the rest of you think this one is the fiction, except for Evan; you thought that 1 was the fiction. And this one is ...

B: Say it!

S: ... science.

B: Argh!

J: Yes, of course it's science.

(Rebecca groans)

B: Three ... I discounted a nanosecond.

R: I cannot believe that Aija misled me.

AM: (Laughs)

S: I loved it! I loved that news item.

E: Well done Aija.

S: Absolutely sure that #3 is science. I love that. Alright. So, yes, I in fact was one of those people who had a benign heart murmur when I was a kid. It was nothing. My parents totally over-reacted. But, as a result of it, I had to take antibiotics every time I went to the dentist. And it was completely not evidence based.

So, systematic review – resulting in standards. Now we have actual, published standard guidelines, evidence based guidelines. This is, again, what the whole evidence based dentistry movement is about. And, Jay, you are absolutely correct; the indications for antibiotic prophylaxis are: You have a prosthetic heart valve, a heart-valve repair with prosthetic material; you have a prior history of infectious endocarditis; or you have a severe congenital heart abnormality.

J: Hey, this means that my dentist is up to date.

S: Yeah!

R: Yeah, apparently.

S: But, everything else; valve repair without prosthetic – meaning something fake, not biological – murmurs; mitral valve prolapse; and all the other stuff they used to do it for, it's not indicated. You don't need to use antibiotics. Those are the updated guidelines.

E: Good.

S: Evidence based guidelines.

E: It's actually a good thing.

J: And what's also interesting here is that because of this, you have to realize that they are saying that antibiotics should be used very sparingly.

S: Yeah. Yeah, yeah, yeah.

J: You know, they're just not shooting at everyone at every chance. They're saying, "Man, these are – I don't want to say dangerous – but these are something to not be abused to such a degree that we're gonna lower how often we use them."

S: Yeah, but it's also that they're just no helpful. The risk of getting endocriditis, unless you have a prosthetic valve or a major heart malformation is just not there. It's not just the risk versus benefit. There really just is the benefit.

R: I bet it was fascinating to be at a dentist conference.

S: It was! It was!

R: And to experience dentist jokes. No, I'm not being sarcastic ...

S: No, no! It was ...

R: I would find it genuinely, like, I find it very funny to think of a bunch of dentists having inside jokes about gingivitis. I love it.

(Rogues laugh)

J: This is so truthful. This is the truth: I made my tooth cleaning appointment very recently, and the lady told me I'm getting my time slot is at 2:30.

S: 2:30?

(Groaning)

E: 2:30!

J: I started laughing, and she said, "Don't."

(Laughter)

E: She's only heard it a thousand times.

S: Awesome, awesome.

S: Alright, #3: Daily tooth brushing is associated with an increased of receding gums. That one is the fiction because systematic reviews show that the answer is equivocal. We just don't know if there's an association there or not. There's no evidence that it is. Now, how often should you brush your teeth? That's a really good question.

R: Twice a day.

E: Well, that's the standard.

J: Ideally, it's after every time you eat.

E: That's what, kind of what ...

R: We've had this discussion on SGU before about how, if you drink orange juice at breakfast, should you brush your teeth? Because then it'll wear away ...

S: Yeah, I asked them about that too. They were like, "Nah, you're not gonna wear your enamel away. Don't worry about it."

S: And the critical factor is how much time the brush has in contact with your teeth. That's pretty much it. How long does it take you to brush your teeth, Jay?

J: You should...

E: Two minutes.

J: Your tooth brush needs to come in contact with each tooth for at least three seconds.

S: Well, I don't even think that's enough. But your total tooth brushing should be about three to four minutes.

B: Screw that! What the hell?

E: Who's got that kind of time?

J: Steve, not with an electric toothbrush.

S: I don't know, that, Jay, I don't know. I did not specifically look at the electric toothbrush factor. But ...

R: Yeah, I just go until my toothbrush tells me to stop.

S: It's ... average person brushes their teeth for about 45 seconds, you should be brushing for three to four minutes.

AM: Does the strength of the bristles matter?

S: Well, you should use a soft, you should use the soft bristles. But the bottom line with the flossing is that you're probably better off converting your flossing time into brushing time.

B: Oh my god! That's right!

S: The time you waste flossing your teeth, which is not proven to be of any benefit, except maybe, maybe for gingivitis, but if you spent that time brushing your teeth, you'll get the stuff out of your teeth. That's the other thing, is that if you brush long enough, you will get the stuff out.

J: No way!

E: Some people get food pockets between their teeth, and they experience a lot of pain and discomfort, so you have to floss to get that out.

S: That's different. If you have, I have this one place in one of my teeth that I cannot brush stuff out of that one little spot. So, I use instruments to get stuff out of that one spot.

E: Right.

S: But, so that's, you know, if you need to floss to get to certain locations to remove food particles, I suppose that's good. But there's just no evidence that it improves the health of your teeth.

(Jay groans)

AM: I feel like I've been so misguided by my dentist. (Laughs)

S: Yeah! I think the conventional wisdom - this is the whole point – the conventional wisdom is not as evidence based as you think!

B: Wow.

S: And when you actually do the systematic reviews, like, "Oh! Look at that! You know, there really isn't a lot of evidence for flossing!" You're better off just spending a lot of time brushing your teeth.

J: But, you know, guys, take the time. Spend time with your mouth. Don't be afraid to ...

(Laughter)

E: I'll do that right ...

J: I read news items on my phone while I brush my teeth. That's how long I do it.

R: (Snickering) Spend time with your mouth.

S: Jay Novella!

R: I want to see an elementary school poster encouraging kids to brush their teeth with Jay on it, a cartoon Jay saying, "Spend time with your mouth kids."

Science is more than a body of knowledge. It is a way of thinking; a way of skeptically interrogating the universe with a fine understanding of human fallibility. If we are not able to ask skeptical questions, to interrogate those who tell us that something is true, to be skeptical of those in authority, then, we are up for grabs for the next charlatan (political or religious) who comes rambling along.

This was a quote that was sent to me by a friend of mine named Fred Bremmer. Friend of the SGU.

B: Fred!

J: Very long time.

R: Good ol' Fred.

J: And of course Fred sent me quotes from (shouting) Carl Sagan! Because he knows how powerful that man's words are. Yes, thank you Fred.

S: Alright, guys, don't forget, we have The Amaz!ng Meeting coming up in July; and when you register for The Amaz!ng Meeting, be sure to use the code SGUTAM2014 to get your $25 discount. Aija, I understand you're going to TAM this year.

AM: I am. And, what's the code called again?

S: SGUTAM2014.

AM: Alright.

S: It's one of our guideline, in a code.

(Laughter)

S: Alright, Aija, did you have a good time?

AM: I did! That was a fun experience, that's for sure.

B: I'll bet you liked it.

E: Awesome.

B: Thanks for joining us.

S: Yep. Thank you for your support of the SGU. We really do appreciate it.

J: Absolutely.

E: Yeah, very much so. Thank you so much.

J: Aija, was there anything that was different than you thought it would be? Like, what was your experience like?

AM: To be honest with you, I've been quite nervous through this experience, and I wasn't quite sure what to expect, and that I was also worried with the technology as well, because before, when I did the test run with Evan, a few things kind of didn't go smoothly. And then I tried to use other tools, and it didn't work. And I was like, "Oh goodness, I get to call you back?" We tried a few times, and we finally got it working.

E: But we worked it out! That's why we did it ahead of time.

AM: Yes, for sure.

E: Yep.

S: Well, you did a great job. Alright, again, thank you all for joining me this week.

J: (Aristocratic accent) Thank you, Steve.

R: Thank you, Steve.

B: Surely

AM: Yeah, thanks!

S: And until next week, this is your Skeptic's Guide to the Universe.

S: The Skeptics' Guide to the Universe is produced by SGU Productions, dedicated to promoting science and critical thinking. For more information on this and other episodes, please visit our website at theskepticsguide.org, where you will find the show notes as well as links to our blogs, videos, online forum, and other content. You can send us feedback or questions to info@theskepticsguide.org. Also, please consider supporting the SGU by visiting the store page on our website, where you will find merchandise, premium content, and subscription information. Our listeners are what make SGU possible.